Institute of Liver, Pancreas Diseases& Organ Transplantation

Know the facts...

Liver Cancer

Can a liver transplant be done for liver cancer?

If I have been diagnosed to have liver cancer, what

questions should I ask my doctor?

Surgery is the most effective therapy for most types of

liver cancer, but doctors will usually combine different

methods to treat the cancer most effectively. When

surgery to remove the cancer itself cannot be

performed, your doctor may suggest a liver

transplantation in which the cancer along with the entire

liver is replaced thus curing the patient.

You and your family should have a clear

understanding of the disease and the treatment plan.

� What is my diagnosis?

� What is the stage of the disease?

� What are my treatment choices? Which do you

recommend for me? Why?

� What are the chances that the treatment will be

successful?

� What are the risks and possible side effects of each

treatment?

� How long will my treatment last?

� Will I have to change my normal activities?

� What is the treatment likely to cost?

� What are the prospects for liver transplantation?

FACTS AT A GLANCE

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Liver cancer is the uncontrolled growth and spread

of unhealthy cells in the liver.

Cancer that starts in the liver is primary liver cancer.

Cancer that spreads to the liver from another organ

is metastatic or secondary liver cancer.

Risk factors for primary liver cancer are liver

cirrhosis, chronic hepatitis B and chronic hepatitis C

infections.

Early cancer usually has no symptoms.

Doctors often recommend regular liver cancer

screenings for those at increased risk for liver

cancer.

Liver cancer is usually diagnosed by specialized

imaging tests.

Liver cancer that is detected early can be effectively

treated.

Treatment of liver cancer depends on the condition

of the liver, the size, location, and number of tumors,

if the cancer has spread outside the liver, and the

person's age and overall health.

Patients with liver cirrhosis and liver cancer that

cannot be treated by other means can be cured by

liver transplantation

Global Hospitals6-1-1070/1to4, Lakdi-ka-pul,Hyderabad - 500 004.Ph: +91 40 2324 4444 (10 lines)

Aware Global HospitalsSagar Road, L.B.Nagar,Hyderabad - 500 035,Ph: +91 40 2411 11

Hyderabad | Chennai | Bengaluru | Mumbai

Emergency: 040 2324 4444

Specialties:

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Liver Diseases Neurosciences Medical Gastroenterology Therapeutic Endoscopy Bariatric Surgery

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Hepatobiliary SurgeryOncology Critical Care Minimal Access Surgery

And other services

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Cardiac Sciences Multiorgan Transplantation Surgical Gastroenterology Endocrinology Pancreatology

www.globalhospitalsindia.com

Prof. Mohammed Rela, MBBS, MS, FRCS (Edinburgh)Head of Multi-organ Transplantation and HPB SurgeryGlobal Hospitals Group

THE HYDERABAD TEAMDr. Dharmesh Kapoor (Transplant Hepatologist)Dr. Balbir Singh (Transplant and HPB Surgeon)

What is liver cancer?

What is the difference between liver tumour and

liver cancer?

What are the causes of primary liver cancer?

Liver cancer is the uncontrolled growth and spread of

unhealthy cells in the liver. Cancer that starts in the liver

is primary liver cancer. Cancer that spreads to the liver

from another organ (such as bowel or breast) is known

as secondary or metastatic liver cancer.

Any mass or nodule in the liver is known as a liver tumor.

Liver tumors can be non-cancerous (benign) or

cancerous (malignant). The most common type of

cancer that originates in the liver is hepatocellular

carcinoma (HCC).

There is no one cause of primary liver cancer. Several

factors increase a person's likelihood of developing

liver cancer. Some risk factors for liver cancer include:

� Viral hepatitis - Hepatitis B virus (HBV) and

Hepatitis C virus (HCV) infections are an important

cause for the development of liver cancer. It is

estimated that about 5-10 percent of people with

HBV or HCV will develop liver cancer.

� Cirrhosis is a progressive disorder that leads to

scarring of the liver. Cirrhosis is the end result of all

forms of long standing liver damage. Cirrhosis is

caused by Hepatitis B, Hepatitis C, alcohol abuse,

fatty liver and certain genetic disorders. 5-10

percent of patients with

cirrhosis will develop liver

cancer.

� Toxins such as Arsenic -

Drinking water (usually

well water) contaminated

with arsenic also increase

risk for developing liver

cancer.

� Obesity may increase the risk of liver cancer.

� Diabetes can increase the risk of liver cancer,

especially in those who drink alcohol heavily or have

chronic viral hepatitis B or C infection.

Liver cancer usually has no obvious symptoms, and

people at risk should be followed regularly to detect

cancer at an early stage. The following symptoms might

be caused by liver cancer:

� Unexplained weight loss

� Anorexia (persistent lack of appetite)

� Early satiety (feeling very full after a small meal)

� Persistent abdominal pain

� Increasing abdominal girth (swelling of the

"stomach" area) with or without breathing difficulty

� Sudden jaundice (yellowness of the skin and eyes)

� Sudden deterioration in the overall condition of a

patient with cirrhosis

� Liver enlargement or a mass that can be felt in the

area of the liver

If liver cancer is suspected, the doctor will conduct a

physical examination and order special tests. Further

tests may include alpha-fetoprotein (AFP) blood test,

ultrasound scan, computed tomography (CT),

magnetic resonance imaging (MRI), angiography,

laparoscopy and biopsy. It is important to detect liver

cancers early because small cancers in a patient who

has minimal symptoms can be treated effectively.

What are the symptoms of liver cancer?

What tests will I have to detect liver cancer?

What is liver cancer screening

How is Liver Cancer treated ?

Diferent ways of treating Liver cancer

Liver cancer screening is the best way to detect liver

cancer early in its course. It is performed to detect small

cancers that do not produce any symptoms. Small

cancers can be treated more effectively. Patients who

have a liver disease that puts them at a high risk of

developing liver cancer (such as hepatitis B, any form of

cirrhosis) should undergo periodic screening tests. It

usually involves a blood test to look for a cancer marker

(alpha-feto-protein) and an ultrasound scan of the liver

to look for actual cancer. You must understand that

screening tests are not 100 percent accurate and your

doctor may advise you additional tests if he suspects

that you may have a liver cancer.

Liver cancer treatment depends on:

� The liver's condition

� The size, location, and number of tumors

� If the cancer has spread outside the liver

� The person's age and overall health

Surgery

If the cancer has been found early and the rest of the

liver is healthy, doctors may perform surgery to remove

the tumor from the liver.

A Healthy Liver… A Healthy Life…

Cryosurgery

Cryosurgery uses a metal probe to freeze and destroy

cancer cells.

Radiofrequency Ablation

Radiofrequency ablation uses a special probe to

destroy cancer cells with heat using special needle. The

procedure is performed under ultrasound or

laparoscope guidance.

Chemotherapy or chemoembolization

C h e m o t h e r a p y

uses anti-cancer

drugs to destroy

cancer cells. In

some cases, the

chemotherapy can

be directly injected

into the liver tumor.

Radiation Therapy

Radiation therapy uses radiation (high-energy x-rays) to

destroy cancer cells.

Sorafenib

Sorafenib is an oral medication for use in advanced

cases of liver cancer.